/ 50 possible = ATPE 412 Exam #3 - Spring 05

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1 ATPE 412 Exam #3 - Spring 05 CASE STUDY Big Bubba tore his ACL and anterior-lateral meniscus of his right knee on April 1 st of He had surgery on April 25 th using a patellar tendon autograft and the surgery was a success. He is coming to you 2 days post-surgery for the beginning of rehabilitation. Baseline testing shows that Bubba has 75 of knee flexion, -5 of knee extension, pain is 5/10 (10 being the worst pain), he is currently taking Vicodin once a day and Ibuprofen 3 times a day. He is unable to make a voluntary quad contraction. 1. Which of the following would be most appropriate for the first day s rehabilitation session (no modalities yet)? a. Perform SLR & mini-squats b. Friction massage to scars over arthroscope holes c. Grade 3 joint mobilization to increase knee extension d. Quad sets & Ankle pumps e. Stationary bike to increase ROM 2. What is the textbook s term for the lack of extension that Bubba has: (2 points) It is now 8 days post-surgery. Bubba s ROM has improved to 95 of flexion and -4 of extension. He is now able to make a voluntary quad contraction. Bubba is coming to you from the doctor s office where he just had his stitches removed. His pain is now at a 3/10 and is no longer taking Vicodin. 3. To increase his knee extension, which of the following would be effective: a. Grade II Posterior femoral glide on stable tibia b. Inferior patellar glide c. Grade III Posterior tibial glide on stable femur d. Prone hangs e. All of the above f. Both A & B g. None of the above 4. Which of the following would be detrimental to the healing process of his knee? a. OKC leg extensions from 85 to 60 b. Mini-squats c. Step-ups to 4 inch platform

2 d. Short arc quads e. Hamstring curls

3 It is now 4 weeks post-op. Big Bubba has 126 of flexion and 0 of extension. He has progressed well but complains of patellar tendon problems at the tibial tubercle. 5. Which of the following exercises should you avoid? a. Mini-squats b. TKEs c. Leg press d. Stationary bicycling 6. Which of the following are predisposing factors for Bubba s patellofemoral problems? a. Hip External rotation b. Gluteus Maximus weakness c. External tibial torsion d. Excessive supination 7. According to the textbook, which of the following exercises would be most likely to recruit the VMO to assist in Bubba s PFPS? a. Plies b. Wall squats c. Leg Press d. Lunges 8. Bubba really wants to run. He is getting fat, he smells, and his love life is going down the drain. You have explained to him that he is not ready due to the strength of the graft, but he needs to hear it again. Please explain why he can't run at this time. (3 points) 9. What are the advantages and disadvantages of Bubba s BTB graft instead of a hamstring graft? (3 points)

4 CASE STUDY Erica, a water polo player, has been diagnosed as having subacromial impingement. After evaluation you feel that it is the supraspinatus that is impinging on the acromion process of her throwing shoulder. X-rays did not reveal any bone spur or anatomical anomaly of her subacromial space. She has 110 degrees of abduction, 75 degrees of flexion, and 15 degrees of internal rotation. Today is her first day of rehabilitation and she hopes to play on Saturday in the next match. 10. What type of impingement does Erica have? a. Primary b. Secondary c. Internal d. None of the above 11. Since she is a water polo athlete and a swimmer, her posture is that of rounded shoulders and weak scapular retractors, which of the following muscles is most likely to be excessively tight? a. Pectoralis Major b. Pectoralis Minor c. Scalenes d. Trapezius 12. You have determined that you will focus on lower trapezius exercises, which of the following exercises will achieve your focus? a. Jobe s exercises b. Bouhler s exercises c. Codman s pendulum exercises d. None of the above 13. As you begin to strengthen the rotator cuff muscles, the exercises that you have Erica perform should in a ROM below of abduction. a. 30 b. 60 c. 90 d. 120 {end of case study} 14. In the first week after a Tommy John surgery, which of the following exercises are NOT appropriate? a. Ball squeezes

5 b. Submaximal isometrics for biceps c. Active wrist and finger exercises d. All are appropriate 15. According to our class discussion, most shoulder rehabilitations should focus on these 3 key concepts, what are they? a. b. c. 16. In valgus extension overload, which part of the elbow develops a bony hypertrophy? a. Posterolateral olecranon b. Posteromedial olecranon c. Capitellum d. Lateral lip of Trochlea 17. Of the four types of elbow dislocations, which one is most common? a. Posterior b. Posterolateral c. Posteromedial d. Lateral 18. Which of the following should NOT be done during the first 5 days of rehabilitation for a patient with an elbow dislocation? a. Immobilization in posterior splint b. Passive ROM c. Isometric shoulder exercises d. Isometric gripping exercises 19. According to the notes, what were the 3 simple keys to elbow rehabilitation? a. b. c. 20. Joe is a baseball pitcher for your high school varsity baseball team, he has been cleared to pitch by his family physician, but you have determined that he needs to go through a throwing progression program. Describe how you would design and implement a throwing program for Joe. (3 points)

6 21. Sally is a basketball player and she has PFPS. Describe how you would rehabilitate her injury including the specific focus of her rehabilitation, what exercises you would include, and what exercises you would avoid and why. (5 points)